Leukocyte Esterase Activity in Vaginal Fluid of Pregnant andNon-Pregnant Women With Vaginitis/Vaginosis and in Controls

摘要

Objectives:To determine the leukocyte esterase (LE) activity in vaginal lavage fluid of women with acute andrecurrent vulvovaginal candidosis (VVC and RVVC respectively), bacterial vaginosis (BV), and in pregnant andnon-pregnant women without evidence of the three conditions. Also to compare the result of LE tests in womenconsulting at different weeks in the cycle and trimesters of pregnancy.The LE activity was correlated to vaginal pH,number of inflammatory cells in stained vaginal smears, type of predominating vaginal bacteria and presence ofyeast morphotypes.Methods:One hundred and thirteen women with a history of RVVC, i.e. with at least four attacks of thecondition during the previous year and who had consulted with an assumed new attack of the condition, werestudied. Furthermore, we studied 16 women with VVC, 15 women with BV, and 27 women attending for controlof cytological abnormalities, who all presented without evidence of either vaginitis or vaginosis. Finally, 73pregnant women were investigated. The LE activity in vaginal fluid during different weeks in the cycle of 53 ofthe women was measured.Results:In the non-pregnant women, an increased LE activity was found in 96, 88, 73 and 56% of thosewith RVVC, VVC and BV and in the non-VVC/BV cases, respectively. In 73% of pregnant women in the secondtrimester, and 76% of those in the third, the LE test was positive. In all groups of non-pregnant women tested,the LE activity correlated with the number of leukocytes in vaginal smears, but it did not in those who werepregnant. There was no correlation between LE activity and week in cycle. The vaginal pH showed no correlationto LE activity in any of the groups studied.Conclusions:The use of commercial LE dipsticks has a limited value in the differential diagnosis of RVVC, VVCandBV. There is no correlation between the LE activity in vaginal secretion on one hand and vaginal pH, week inthe menstrual cycle and trimester in pregnancy on the other. Women with BV often have signs of inflammationas evidenced by a positive LE test and inflammatory cells in genital smears.